Healthcare’s biggest losers: Which states are harmed the most under the Senate TrumpCare plan?

In their campaigns, Republican candidates for Congress and the presidency were unanimous in denunciations of the Affordable Care Act (ACA) for increasing health insurance premiums and deductibles. Senate Republicans are struggling to pass a plan called the “Better Care Reconciliation Act” (BCRA) that would increase premiums and deductibles even higher than those currently paid under the ACA.

Gary Claxton, Anthony Damico, Larry Levitt, and Cynthia Cox of the Kaiser Family Foundation have estimated the increases in premiums for plans matching the extent of coverage currently available under ‘silver’ plans for the year 2020. To focus on the impact on family budgets, they report premium amounts after the tax credits that subsidize purchases of health insurance are accounted for. Kaiser researchers found that marketplace enrollees would pay on average 74 percent more toward the premium for a benchmark silver plan in 2020 under the BCRA than under current law.

Economic Snapshot

Which states are harmed the most under the Senate TrumpCare plan?: Average premium cost increases by state, 2020

State

Percentage

ObamaCare

BCRA

Alabama

164%

$156

$411

Alaska

142%

$332

$804

Oklahoma

140%

$199

$477

South Dakota

111%

$238

$501

North Carolina

109%

$187

$391

West Virginia

108%

$282

$585

Louisiana

105%

$179

$368

California

103%

$190

$386

Nebraska

99%

$223

$442

Hawaii

89%

$208

$394

Montana

89%

$269

$507

Tennessee

86%

$233

$434

Wyoming

84%

$197

$363

Kansas

82%

$208

$379

Mississippi

79%

$120

$215

Texas

78%

$182

$325

Wisconsin

78%

$234

$418

Missouri

77%

$175

$308

North Dakota

76%

$217

$381

Connecticut

75%

$280

$488

Iowa

75%

$224

$391

Maryland

74%

$191

$333

Nevada

73%

$168

$292

Pennsylvania

72%

$234

$403

Georgia

71%

$170

$291

Idaho

71%

$171

$291

Florida

69%

$140

$237

Michigan

69%

$165

$279

Utah

67%

$144

$241

South Carolina

66%

$157

$262

Virginia

66%

$182

$302

Colorado

65%

$333

$552

Minnesota

65%

$389

$640

Arkansas

60%

$188

$299

Delaware

60%

$241

$385

Rhode Island

60%

$162

$259

New Mexico

59%

$248

$395

Illinois

57%

$248

$390

Oregon

54%

$257

$395

Arizona

53%

$328

$503

Ohio

52%

$223

$338

Kentucky

49%

$236

$352

New Jersey

49%

$223

$333

Indiana

48%

$207

$307

Maine

48%

$203

$301

New Hampshire

43%

$242

$347

Washington

33%

$213

$282

Washington D.C.

22%

$409

$497

Vermont

21%

$292

$354

Massachusetts

14%

$149

$169

New York

12%

$358

$400

Data are for average premiums that current marketplace enrollees would pay, after receiving any premium tax credit, for a benchmark silver plan in 2020 under current law and under the BCRA

In Alabama, for example, premiums would increase 164 percent from $156 a month to $411 under the BRCA. In Alaska, they would increase 142 percent from $334 a month to $802 a month. The reductions in premium subsidies, in concert with tax cuts for the wealthy, will cost Americans jobs as well. Because low- and moderate-income households tend to spend a much higher share of their disposable income, the overall effect of the BCRA would be less spending and lower aggregate demand across every state and congressional district.

This pain is highly unequal in its distribution, in more ways than one: There are differences in net premium increases among the states. These results actually understate the increases in out-of-pocket costs under BCRA since they do not reflect the higher deductibles that would be imposed.

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EPI is an independent, nonprofit think tank that researches the impact of economic trends and policies on working people in the United States. EPI’s research helps policymakers, opinion leaders, advocates, journalists, and the public understand the bread-and-butter issues affecting ordinary Americans.